Phase 2: Wave 1: seniors, near-seniors, and children · Step 2.1

Upgrade Medicare enrollees into UHP

All 67 million Medicare enrollees move into UHP on day one. Part B and Part D premiums, deductibles, and coinsurance end. Dental, vision, and hearing are added.

Legal vehicle

Universal Health Act, Title VIII (transition); repeal of SSA §§1839, 1860D-13 premiums.

Who does it

UHA

When

Year 1, Day 1

In this step

Tasks

7 tasks

Design choice & alternatives

1 decisions with alternatives

Costs & calculations

1 cost items, each with its calculation

Trade-offs

3 pros · 2 cons · 2 trade-offs

Risks

1 risks with mitigations

What changes in the system

8 existing laws, programs, or institutions changed

Other countries

3 comparisons

Cost items

Medicare Part B & D premiums$0.0B

Depends on

1.1 Create the Universal Health Administration
1.3 Build the claims, payment & data systems
1.4 Enroll everyone automatically

Steps that depend on this one

2.2 Enroll children and adults 55–64

Sources: Medicare Payment Advisory Commission (2025)